Clear cell sarcoma: a case mimicking primary cutaneous malignant melanoma.

Clear cell sarcoma (CCS) is a recently described variant of sarcoma characterized by prominent clear cells showing features similar to clear cell melanoma. This neoplasm was first described by Dr. Franz M. Erzinger. Primary CCS usually arises in deeper soft tissues, in association with fascia, tendons, or aponeuroses. Characteristic translocation t(12;22) (q13;q12) has been considered pathognomonic for CCS. Prognosis is related to tumor size. An early recognition and initial radical surgery is the key to a favourable outcome. We present a patient with an unusual neoplasm that resembled malignant melanoma.

Randomized, double-blind clinical trial to evaluate the efficacy of topical tacalcitol and sunlight exposure in the treatment of adult nonsegmental vitiligo.

BACKGROUND: Vitiligo is a common skin disease which is difficult to treat. Approximately half of patients acquire the disease before the age of 20 years. This disease has a high stigmatizing impact but no ideal, aetiology-oriented, effective therapy has been found to date. Tacalcitol and other vitamin D analogues have been shown to have stimulating activity both on immunomodulatory mediators and on melanocytes in lesional skin. OBJECTIVE: To investigate the efficacy and safety of tacalcitol ointment plus sunlight exposure in the treatment of nonsegmental vitiligo. METHODS: A single-centre, randomized, double-blind, vehicle-controlled study including 80 patients with nonsegmental vitiligo was carried out in a specialized outpatient dermatology clinic within a tertiary care, university-affiliated hospital in Spain. Efficacy was assessed by quantification of the lesional repigmentation area at the end of the study compared with the baseline. Tacalcitol (n = 40) or matching placebo ointment (n = 40) was applied once a day at night. Daily exposure to sunlight for 30 min was performed. Treatment was continued for 4 months. The response of the lesions was clinically verified every 2 weeks by a blinded medical investigator. All adverse effects were recorded. RESULTS: Eighty adult patients with nonsegmental vitiligo were recruited. Over 16 weeks, 64 patients completed the study requirements. There was no significant difference in the repigmentation response at the 16-week time point between the vehicle + sunlight exposure and the tacalcitol + sunlight exposure groups. No reduction in the size of the lesions > 25% was observed in the tacalcitol-treated patients. No serious adverse effects were observed. CONCLUSION: The combination of tacalcitol with heliotherapy has no additional advantages compared with heliotherapy alone.

Bortezomib-induced cutaneous lesions in multiple myeloma patients: a case report.

Proteasome inhibitors are emerging as a promising class of anti-cancer therapeutic agents. Bortezomib (PS341) is the first proteosome inhibitor with clinical significance. It acts by blocking vital functions of tumoral cells in myeloma, inducing apoptosis. Its toxicity is usually manageable. Gastrointestinal symptoms, peripheral neuropathy, neuropathic pain and thrombocytopenia are described as the most common side effects. We report on a case of cutaneous lesions induced by bortezomib in a patient with relapsed multiple myeloma (MM).

Naevus lipomatosus cutaneous superficialis on the nose.

Naevus lipomatosus cutaneous superficialis (NLCS) is an uncommon hamartomatous lesion with an exceptional presentation on the face. We report the case of an elderly patient who presented with a classic type of NLCS on the right nasal orifice. This patient was taking inhaled steroids for his allergic rhinitis during 35 years.

Localized lichen myxoedematosus (papular mucinosis) associated with morbid obesity: report of two cases.

Cutaneous diseases are often found in obese patients but, to our knowledge, mucinous disorders have not been previously reported in association with obesity. Two cases of localized lichen myxoedematosus (papular mucinosis) in two women with morbid obesity are described. Both patients underwent a low-calorie diet for a 1-year period in one case, and for 4 months in the other one, as the only treatment. There was complete resolution of cutaneous lesions at the same time that an important weight loss was observed. Nevertheless, although spontaneous regression is not frequent, it could not be disregarded in either of these two cases.

The role of psychological factors in palmoplantar pustulosis.

OBJECTIVE: The aim of the present study was to find out whether emotional stress is related to palmoplantar pustulosis (PPP). SUBJECTS AND METHODS: Our 21 patients with palmoplantar pustulosis and 21 age- and sex-matched controls were studied with the help of a psychological interview and two psychological tests: Eysenk's Personality Questionnaire for Adults (EPQ-A) and Inventory of Situations and Response of Anxiety (ISRA). RESULTS: Anxiety, ranging from moderate to severe was higher in PPP patients than in controls (P < 0.001). CONCLUSION: Our findings seem to indicate that stress may be related to exacerbation of the palmoplantar pustulosis.

Queratosis seborreicas irritadas simétricas en paciente con trasplante renal / Simetric irritated seborrhoeic keratoses in a renal transplant recipient

La queratosis seborreica es uno de los tumores epidérmicos benignos más frecuentes encontrados en la práctica clínica. Su transformación maligna es excepcional. Presentamos el caso de la aparición inusual de dos queratosis seborreicas irritadas simétricas en los brazos de un trasplantado renal (AU)

Primary cutaneous mucormycosis: a diagnosis to consider.

Primary cutaneous mucormycosis is a deep fungal infection, mainly seen in diabetics and immunocompromised subjects. Rapid diagnosis and therapy are necessary to avoid fatal outcome. We describe the complete histopathological and microbiological studies of primary cutaneous mucormycosis in a 74-year-old man with several risk factors, such as chronic obstructive pulmonary disease, respiratory acidosis, hemolytic anemia, myelodysplastic syndrome and iatrogenic diabetes, due to corticosteroid therapy. He developed two cutaneous necrotic scars on his left leg. Mucormycosis was suspected and specimens from surgical débridement were histopathologically and microbiologically studied confirming the clinical diagnosis. Amphotericin B was given topically and intravenously resulting in complete healing of the ulcer. Risk factors and microbiological studies are compared with those in the current literature. It is necessary in certain cases to suspect mucormycosis infections in diabetics, immunocompromised subjects and even in healthy individuals. Rapid diagnosis and treatment are important, but they should be based on complete histopathological and microbiological studies, to establish the genus of the causal agent.